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Volume 71, Issue 3, Pages 468-474 (March 2010)


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Endoscopic removal of dysfunctioning bands or rings after restrictive bariatric procedures

Daniel Blero, MD, PhDCorresponding Author Information, Pierre Eisendrath, MD, Alain Vandermeeren, MD, Jean Closset, MD, Abdel Mehdi, MD, Olivier Le Moine, MD, PhD, Jacques Devière, MD, PhD

Received 23 February 2009; accepted 17 June 2009. published online 14 September 2009.

Background

Intragastric band migrations or dysfunctions are common long-term complications of both vertical banded gastroplasty (VBG) and laparoscopic adjustable gastric banding (Lap-Band) that classically require surgical treatment.

Objective

In this series, we describe the endoscopic removal of partially eroded Lap-Bands or Silastic rings and noneroded dysfunctioning rings after VBG.

Design

Case series.

Setting

A European, tertiary-care academic center.

Patients

This study involved 13 patients—3 with eroded Lap-Bands, 4 with eroded Silastic rings, and 6 with refractory outlet stoma stenosis after VBG.

Intervention

Endoscopic removal was performed within 1 or 2 sessions, according to the presence and extent of band erosion at presentation, including optional placement of a self-expandable plastic stent across the band, followed about 6 to 8 weeks later by extraction with transsection, if needed, by using a wire-cutting system.

Main Outcome Measurements

Technical success and safety.

Results

One failure was caused by huge adhesion formation around a Lap-Band on the lesser curvature of the stomach and the left liver lobe. Twelve of 13 endoscopic removals were successful in 1 (n = 2) and 2 (n = 10) sessions.

Limitations

Highly selected patients (tertiary-case academic center).

Conclusion

Endoscopic removal of dysfunctioning bands or rings is safe and feasible by the use of a 1- or 2-step endoscopic procedure.

Brussels, Belgium

Current affiliations: Department of Gastroenterology and Hepato-pancreatology, Hôpital Erasme, Université Libre de Bruxelles, Belgium

Corresponding Author InformationReprint requests: Daniel Blero, MD, Department of Gastroenterology, Hôpital Erasme, 808 route de Lennik, 1070 Bruxelles, Belgium.

 DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Daniel Blero was supported by a grant from Fonds Erasme pour la recherche Médicale and a Cook Endoscopy grant for research in GI endoscopy.

PII: S0016-5107(09)02120-8

doi:10.1016/j.gie.2009.06.020


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